Fenofibrate is recommended in the treatment of adult endogenous hyperlipidemias, of hypercholesterolemias and of hypertriglyceridemias. A treatment of 300 to 400 mg of fenofibrate per day enables a 20 to 25% reduction of cholesterolemia and a 40 to 50% reduction of triglyceridemia to be obtained.
The major fenofibrate metabolite in the plasma is fenofibric acid. The half-life for elimination of fenofibric acid from the plasma is of the order of 20 hours. Its maximum concentration in the plasma is attained, on average, five hours after ingestion of the medicinal product. The mean concentration in the plasma is of the order of 15 micrograms/ml for a dose of 300 mg of fenofibrate per day. This level is stable throughout treatment.
Fenofibrate is an active principle which is very poorly soluble in water, and the absorption of which in the digestive tract is limited.
Due to its poor affinity for water and to its hydrophobic nature, fenofibrate is much better absorbed after ingestion of food, than in fasting conditions. This phenomenon called “food effect” is particularly important when comparing fenofibrate absorption in high fat meal conditions versus fasting conditions.
The main drawback in this food effect is that food regimen must be controlled by the patient who is treated with fenofibrate, thereby complicating the compliance of the treatment. Yet, as fenofibrate is better absorbed in high fat meal conditions, it is usually taken after a fat meal. Therefore, these conditions of treatment are not adapted to patients treated for hyperlipidemia or hypercholesterolemia who must observe a low fat regimen.
A way to limit the food effect is to increase the solubility or the rate of solubilization of fenofibrate, thereby leading to a better digestive absorption, whichever the food regimen.